How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $83.18 Median $87.10 Typical High $109.65 | Professional | None (both parts) | $83.18 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $43.65 Typical High $54.95 | Professional | 52 · Reduced service | $40.74 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.38 Typical High $21.88 | Professional | 53 · Discontinued | $16.60 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.88 Typical High $16.60 | Professional | 55 · Aftercare only | $12.30 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.32 | $8.71 | $10.96 |
BCBS Tennessee Setting Professional Modifier None (both parts) Typical Low $91.20 Median $104.71 Typical High $169.82 | Professional | None (both parts) | $91.20 | $104.71 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $436.52 Typical High $707.95 | Facility | None | $281.84 | $436.52 | $707.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $79.43 Typical High $223.87 | Professional | None (both parts) | $79.43 | $79.43 | $223.87 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $537.03 Median $537.03 Typical High $575.44 | Professional | None (both parts) | $537.03 | $537.03 | $575.44 |
United Setting Professional Modifier None (both parts) Typical Low $87.10 Median $104.71 Typical High $190.55 | Professional | None (both parts) | $87.10 | $104.71 | $190.55 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier TC · Technical part Typical Low $77.62 Median $102.33 Typical High $112.20 | Professional | TC · Technical part | $77.62 | $102.33 | $112.20 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $91.20 Median $120.23 Typical High $173.78 | Professional | TC · Technical part | $91.20 | $120.23 | $173.78 |
Lucent Health Setting Professional Modifier TC · Technical part Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | TC · Technical part | $467.74 | $467.74 | $467.74 |
Where Tennessee sits
The same service costs 2.9 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Tennessee· 21st of 51
$112
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.